Disparities in health care among racial and ethnic minorities are prevalent in the United States. These disparities are particularly pronounced in cardiovascular disease, where the rate of mortality and cardiac events are higher than for Caucasians. A fundamental step to eliminating these disparities is the ability to identify them and implement strategies to promote evidence-based and equitable care. Data-driven approaches that foster the collection and sharing of accurate and reliable data on patients' race and ethnicity hold great potential to reduce disparities through the application of these data in quality improvement and performance improvement initiatives. However, the clinicians who provide a significant proportion of care to minority patients are often challenged by a lack of infrastructure and resources to support quality measurement and improvement. To assist under-resourced practices in high-disparity areas in improving quality of care, the American College of Cardiology Foundation (ACCF) will implement the PEER QI (Promoting Equity through Expansion of Registries for Quality Improvement) Initiative. By providing high-need practices with a tool to collect accurate clinical data, PEER QI will implement quality improvement and performance improvement strategies to identify and improve adherence to performance measures and clinical guidelines, especially for minority populations. PEER QI will enroll targeted practices that primarily serve racial and ethnic minority populations in the PINNACLE Registry, the first outpatient cardiovascular registry in the United States, to address key challenges in assessing disparities in care by providing physicians with performance feedback that will enable them to implement interventions and change their behaviors in order to close existing knowledge and performance gaps.